Polio returns to US after vaccination coverage declines

“Polio is rampant in Rockland County. Our new generation is at risk,” warns a poster on the wall of a supermarket in the suburban New York suburb of Pearl River. doing.

It marks the resurgence of the disease as a public health threat 40 years after U.S. officials eliminated its transmission in a national childhood vaccination program. Hochul is had to declare After the virus was detected in the wastewater of several counties, fears arose that a disaster emergency could have resulted in thousands of asymptomatic infections.

That was in July, following the diagnosis of the first polio case in the United States since 2013. His infection was linked by gene sequencing to vaccine-derived polio (VDP) in London wastewater and several infected children in Israel, although he did not travel abroad during the incubation period. I did.

VDP is a disease that occurs when vaccination coverage is low. It is caused by the attenuated poliovirus contained in the oral polio vaccine, which is given to many children in developing countries. If low vaccination coverage allows this weakened virus to circulate in large numbers, it may mutate and lead him to VDP, which can cause paralysis. Most developed countries, including the United States, administer injectable vaccines containing inactivated poliovirus without the risk of mutation.

Experts say cases of VDP in rich countries are linked with recent outbreaks of wild polio in Afghanistan, Pakistan, Malawi and Mozambique alongside Covid-19, increased vaccine hesitation, war and climate-related shows how the virus is taking advantage of the disruption to vaccination programs caused by the disaster. They warned that this was a wake-up call to health authorities, who launched a global campaign in 1988 to eradicate diseases that can kill or disable children. is doing.

“As long as polio is present anywhere in the world, it poses a threat everywhere, especially as international travel is picking up again,” said some of the organizations spearheading the Global Polio Eradication Initiative. says Carol Pundak, a PolioPlus director.

Founded in 1988 by a World Health Assembly resolution, Gpei had the goal of eradicating polio by the year 2000 through a global childhood immunization campaign funded by the public and private sectors. While it fell short of its ambitious goal, by spending about $19 billion to purchase and distribute 2.5 billion vaccines, the initiative helped reduce the number of polio cases by 99.9% to an estimated 20 million people. child from paralysis.

Gpei’s work has helped eradicate two of the three wild poliovirus strains over the past decade. And the virus is now endemic in just two of his countries, Afghanistan and Pakistan, compared to 125 countries where vaccination campaigns have been launched.

But experts now say this progress could be wasted unless governments and donors can find an additional $4.8 billion to fund a five-year plan to boost vaccination coverage. I warn you.

Nearly 7 million more children missed their third dose of the polio vaccine last year compared to the pre-pandemic year of 2019, according to World Health Organization data released in July. The decline in overall childhood immunization in 2021 was the largest in his 30 years, with at least 25 million of her infants missing routine immunizations.

“Polio is becoming a major threat again, and if it spreads to too many areas, it risks becoming impossible to eradicate,” said Zulfi Bhutta, director of children’s global health at Toronto’s Children’s Hospital. says Dr.

he coordinated this month’s publication global declaration Over 1,000 scientists have signed the petition calling for their support for Gpei. “You can’t do science in a vacuum, you need resources,” says Bhutta, who cited vaccine hesitance as a key challenge to overcome.

Rockland County, located about 30 miles northwest of New York City, provides a case study of how low vaccination coverage makes communities vulnerable to outbreaks.

About 325,000 people live in this bedroom town. It has a large and growing Orthodox Jewish community and is the target of increasingly vocal anti-vaccine activists.

Childhood vaccination coverage for 2-year-olds in the county averaged 60%, dropping to 37% in some ZIP Code areas. This is well below the 80 percent level that WHO says is necessary to provide herd immunity against polio and the 95 percent level needed for measles.

“This is not a religious issue,” says Rockland Health Commissioner Dr. Patricia Rupert. “Unfortunately, there is a problem in some isolated communities that we see misinformation circulating over the years. The “politicization” of vaccine efforts during the 1990s has deterred many people from getting vaccinated, she says.

Seven million more children missed their third dose of polio vaccine last year compared to 2019, according to WHO

Authorities have set up immunization clinics, stepped up education campaigns and directed medical centers to be polio vigilant. Polio often presents with flu-like symptoms or no symptoms at all.

“There is really no cure for polio, so prevention is key in this case,” said Rupert, adding that Rockland has received 7,000 polio vaccines since July 21.

Wastewater monitoring is an important tool in tracking the spread of the poliovirus to several counties, linking the Rockland case to the UK and Israel. Rockland authorities have begun auditing schools to ensure compliance with the legal requirement that all students be vaccinated. It was introduced in 2019 following a measles epidemic that sickened hundreds of children, mostly in the Orthodox Jewish community.

In developing countries, particularly in Pakistan and Afghanistan, where wild polio remains endemic, poor infrastructure, conflict and climate-related disasters exacerbate the challenge of vaccine hesitation.

But Dr. Jay Wenger, who heads the polio program at the Bill & Melinda Gates Foundation, says that if the $4.8 billion that Gpei is seeking is raised, the goal of eradication can be met.

The recent development and deployment of a new oral polio vaccine, called nOPV2, has provided a new tool for prevention because it is more stable and less likely to cause outbreaks of VDP, he says.

More funding could complete vaccination rollouts in Pakistan and Afghanistan, wipe out VDP outbreaks, and eliminate the risk of spreading the virus. Wenger said: